Sponsors (26)
The bill expands free in‑network maternal mental health and SUD care, continuity protections, and telehealth access—improving treatment access for pregnant and postpartum people—but shifts costs onto insurers/employers (risking higher premiums), leaves out‑of‑network gaps, and delays implementation by two years.
Pregnant and postpartum individuals will receive free in‑network mental health and substance use disorder (SUD) care from diagnosis through one year postpartum, removing a major financial barrier to treatment.
Pregnant people and patients with chronic MH/SUD needs keep access to ongoing care when their plan changes due to strengthened continuity‑of‑care protections, reducing treatment disruptions.
Pregnant and postpartum individuals—particularly in rural and underserved communities—gain no‑cost in‑network telehealth coverage for these services, increasing practical access to care.
Insurers and employers will likely face higher costs to cover the expanded benefits, which could be passed on to consumers as higher premiums or result in reduced benefits elsewhere.
Pregnant and postpartum people who use out‑of‑network clinicians remain exposed to high costs because the rule applies only to in‑network providers.
Pregnant and postpartum individuals seeking immediate relief will face a two‑year delay before the rule takes effect, postponing access to cost‑free care for those currently in need.
Based on analysis of 2 sections of legislative text.
Requires private group and individual health plans to eliminate in‑network cost sharing for mental health and SUD services from pregnancy diagnosis through one year postpartum.
Official title: To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require that group health plans and health insurance issuers offering group or individual health insurance that provide coverage for mental health services and substance use disorder services provide such services without the imposition of cost-sharing from the diagnosis of pregnancy through the 1-year period following such pregnancy, and for other purposes.
Introduced January 22, 2026 by Gwendolynne S. Moore · Last progress January 22, 2026
Prohibits cost sharing for in‑network mental health and substance use disorder (SUD) services for people from the diagnosis of pregnancy through one year after pregnancy, including telehealth. It extends continuity‑of‑care protections so pregnant and postpartum patients can keep ongoing mental health or SUD treatment received during pregnancy. The rule applies to group and individual private health plans (and includes parallel ERISA and Internal Revenue Code provisions) and takes effect for plan years beginning two years after enactment.